In a significant shift, the Trump administration says the entirety of the Affordable Care Act should be struck down in the courts. Previously, the administration had pushed to remove the law's protections for people with pre-existing conditions but had not argued in court that the whole law should be struck down.

The change was announced in a two-sentence letter from the Department of Justice to the Fifth Circuit Court of Appeals, that the ruling made in December by a district court judge in Texas "should be affirmed."

In that case, District Judge Reed O'Connor declared the ACA unconstitutional. He ruled that a 2017 change in federal tax law eliminating the penalty on uninsured people invalidated the entire health care law.